Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine

Evaluation of the clinical and inflammatory responses in exclusively NOTES transvaginal cholecystectomy versus laparoscopic routes: an experimental study in swine

Author Vieira, Josiel P. Autor UNIFESP Google Scholar
Linhares, Marcelo M. Autor UNIFESP Google Scholar
Caetano, Elesiario M. Autor UNIFESP Google Scholar
Moura, Rita M. A. Autor UNIFESP Google Scholar
Asseituno, Vitor Autor UNIFESP Google Scholar
Fuzyi, Rogerio Autor UNIFESP Google Scholar
Girao, Manoel J. B. Autor UNIFESP Google Scholar
Ruano, Jose M. Autor UNIFESP Google Scholar
Goldenberg, Alberto Autor UNIFESP Google Scholar
Filho, Gaspar de Jesus L. Autor UNIFESP Google Scholar
Matos, Delcio Autor UNIFESP Google Scholar
Institution Maranhao Fed Univ UFMA
Universidade Federal de São Paulo (UNIFESP)
Abstract The aim of this study was to evaluate the clinical and inflammatory responses to surgical trauma caused by the natural orifice transluminal endoscopic surgery (NOTES) transvaginal endoscopic procedure compared with those of the laparoscopic route.Twenty-one female swine were divided into three groups of seven animals and subjected to cholecystectomy using laparoscopic, laparotomic, and exclusively NOTES transvaginal routes. A group of five animals served as a control. the animals were monitored during surgery to evaluate anesthetic/surgical time and the presence of complications, which were evaluated after surgery with respect to roaming time, feeding, and the presence of clinical occourrence Measurements of TNF-alpha, IL-1 beta, IL-6, CRP, IFN-gamma were obtained before and after surgery, on the second and seventh postoperative days, and when the animals were killed and necropsied.All procedures were successfully completed as proposed in each group. Perioperative complications consisted of only gallbladder perforation and hepatic bleeding. the anesthetic/surgical time was longer in the NOTES vaginal group (p < 0.001). the postanesthetic recovery time, roaming, nutrition, and clinical evolution were similar in all groups. IL-1 beta and IL-6 were undetectable in all groups. Levels of TNF-alpha, CRP, and IFN-gamma were similar among the groups. However, the evolution of the inflammatory process, measured as the difference between the peak dose and the basal dose of IFN-gamma, was lower in the NOTES group than in the laparotomy group. in the necropsy findings, only adhesions were found, with no difference among the groups.The entirely NOTES transvaginal cholecystectomy was feasible and safe. the surgical time was greater for the NOTES vaginal route. the inflammatory response was similar among the groups based on the levels of CRP and IFN-gamma. However, the evolution of the inflammatory process seems to have been shorter in the vaginal NOTES group than in the laparotomy group as demonstrated by the difference between the peak and basal doses of IFN-gamma.
Keywords Cholecystectomy
Endoscopic
Transluminal
Inflammation
Cytokines
NOTES
Language English
Sponsor Research Support Foundation of the State of São Paulo
Date 2012-11-01
Published in Surgical Endoscopy and Other Interventional Techniques. New York: Springer, v. 26, n. 11, p. 3232-3244, 2012.
ISSN 0930-2794 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 3232-3244
Origin http://dx.doi.org/10.1007/s00464-012-2329-x
Access rights Closed access
Type Article
Web of Science ID WOS:000309879600029
URI http://repositorio.unifesp.br/handle/11600/35452

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